ANAESTHESIA FOR CAROTID ENDARTERECTOMY

INTRODUCTION: Carotid endarterectomy (CEA) is a prophylactic operation. It is performed in patients who are at risk of stroke from emboli arising from atheromatous plaque at the carotid bifurcation. The …

PREGNANCY AND MITRAL STENOSIS

1. Why does pregnancy aggravate the symptoms of mitral stenosis? Women with severe mitral stenosis often do not tolerate the cardiovascular demands of pregnancy because 1. Increase in blood volume …

INTRA OPERATIVE MYOCARDIAL INFARCTION MANAGEMENT

1.            Immediately communicate to the surgery team and the operating room (OR) staff that the patient’s status may be compromised. 2.            Ensure adequate oxygenation; increase the fraction of inspired oxygen …

IS THE PREOPERATIVE DISCONTINUATION OF ACE INHIBITORS NECESSARY?

Introduction: Angiotensin-converting enzyme (ACE) inhibitors are commonly prescribed antihypertensives. This class of drugs is advantageous for control of blood pressure because of its many other therapeutic effects often of value …

Perioperative Management of Patients With Coronary Stents

Introduction: Perioperative coronary stent thrombosis is a catastrophic complication that can occur in patients receiving both bare-metal and drug-eluting stents. Noncardiac surgery appears to increase the risk that recently-placed stents …

MITRAL STENOSIS – Ten Rules for Anesthesia Considerations

Goal: Preload is normal or increased. Afterload is normal. Goal is controlled ventricular response. Avoid tachycardia, pulmonary vasoconstriction The most important hemodynamic goal is to avoid tachycardia (keep heart rate …

AORTIC STENOSIS – Ten Rules for Anesthesia Considerations

Goal: Maintain preload and diastolic filling. Maintain sinus rhythm. Maintain or increase afterload. Avoid myocardial depression. Avoid tachycardia, hypotension, and increased myocardial oxygen demand situations. In the absence of CHF, …

Mitral Stenosis Goal

Mitral Regurgitation Goal

Aortic Regurgitation Goal